Metamorphosis Rehabilitation LLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

Legal business name

METAMORPHOSIS REHABILITATION LLC

Practice address

5170 Sunnyvale Dr
Jackson, MS 39211-4845

Phone

(909) 570-1198

NPI assigned

Feb 28, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Myna Laquisha Burks, PH. D.NPI 1598968802

Title

Owner/Senior Clinician

Phone

(909) 570-1198

Specialties & licenses 6

Addresses

Other names 1

• Metamorphosis Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Tax ID family

Metamorphosis Rehabilitation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Metamorphosis Rehabilitation, LLC

  • Speech-Language Pathologist
  • Jackson, MS
  • NPI 1285478214
  NPD tax ID
• Metamorphosis Rehabilitation, LLC

  • Hearing and Speech Clinic/Center
  • Jackson, MS
  • NPI 1497552079
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Myna Laquisha Burks, M.S. SLP-CCC

  • Speech-Language Pathologist
  • Forest, MS
  • NPI 1598968802
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1295532877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 SUNNYVALE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114845",
            "telephone_number": "909-570-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 SUNNYVALE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114845",
            "telephone_number": "909-570-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHOSIS REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-28",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "BURKS",
        "authorized_official_first_name": "MYNA",
        "authorized_official_middle_name": "LAQUISHA",
        "authorized_official_title_or_position": "OWNER/SENIOR CLINICIAN",
        "authorized_official_telephone_number": "909-570-1198",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metamorphosis Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael T Merchant
• Philip Merideth, MD
• Eric James Merkle, M.D.
• Ashish Vasant Meshram, M.D.
• Kathleen A. Messenger, M.D.
• Metamorphosis Rehabilitation, LLC
• Metamorphosis Rehabilitation, LLC
• Allen Max Metcalf, D.D.S.
• Sallie Gardner Metcalf, OTR/L
• Methodist Children'S Homes

• Hearing and Speech Clinic/Center in Jackson, MS
• Providers in Jackson, MS by specialty
• Hearing and Speech Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.